Strengths and Limitations
Like all retrospective studies, our study is limited by its nature and
the limitations inherent in such a design. Besides, there were fewer
patients in the ORC group compared with nonusers. Although residents
noted the electronic medical records as detailed as possible, we might
have underestimated the adhesion rates because assessment and
description of adhesion is subjective and there has not been a validated
adhesion scoring system to be used for the two procedures. Our study has
several strengths. The inclusion criteria were designed to minimize the
effect of confounding factors as possible such as previous pelvic
operations on the outcomes, and the CSs were performed by three
physicians in the same hospital with profound experience and similar
surgical techniques.